AGATHA Seven Maintenance Cancellation Form

You have informed us of your intention to terminate your AGATHA Seven software maintenance contract.

We have therefore come a long way together and we hope that you have appreciated the ease of use of our software as well as the responsiveness of our after-sales service.

Please be assured that, during all this time, we have done everything to satisfy you and we regret to see you leave already.

To validate your request, please complete and return the following questionnaire:

Date of cancellation request:

Desired date for the effective cessation of maintenance:

First name

Surname

E-mail

Phone

Mailing address

List of practitioners affected by this termination

Reasons for your departure (Retirement with or without a successor,...)

If applicable, name and contact details of your successor

If applicable, the name of the software you wish to migrate to.

Your comments on the AGATHA Seven software

Important note:

We need a minimum of one month to stop automatic maintenance payments.

Although you will still be able to view your patient records, modifications or data entries (Patient Records, Accounting) will no longer be possible once the maintenance is closed.

We therefore advise you to allow an additional 2 months before the complete shutdown of your maintenance.